Occurrence of Paracoccidioides lutzii in the Amazon Region: Description of Two Cases

Silvia Helena Marques-da-Silva Evandro Chagas Institute, Bacteriology and Mycology Section, Mycology Laboratory, Ananindeua, Pará, Brazil; Federal University of São Paulo (UNIFESP), Department of Microbiology, Immunology, and Parasitology, São Paulo, Brazil; CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands; Federal University of Pará, Science Biologic Institute, Belém, Pará, Brazil

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Anderson Messias Rodrigues Evandro Chagas Institute, Bacteriology and Mycology Section, Mycology Laboratory, Ananindeua, Pará, Brazil; Federal University of São Paulo (UNIFESP), Department of Microbiology, Immunology, and Parasitology, São Paulo, Brazil; CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands; Federal University of Pará, Science Biologic Institute, Belém, Pará, Brazil

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G. Sybren de Hoog Evandro Chagas Institute, Bacteriology and Mycology Section, Mycology Laboratory, Ananindeua, Pará, Brazil; Federal University of São Paulo (UNIFESP), Department of Microbiology, Immunology, and Parasitology, São Paulo, Brazil; CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands; Federal University of Pará, Science Biologic Institute, Belém, Pará, Brazil

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Fabíola Silveira-Gomes Evandro Chagas Institute, Bacteriology and Mycology Section, Mycology Laboratory, Ananindeua, Pará, Brazil; Federal University of São Paulo (UNIFESP), Department of Microbiology, Immunology, and Parasitology, São Paulo, Brazil; CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands; Federal University of Pará, Science Biologic Institute, Belém, Pará, Brazil

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Zoilo Pires de Camargo Evandro Chagas Institute, Bacteriology and Mycology Section, Mycology Laboratory, Ananindeua, Pará, Brazil; Federal University of São Paulo (UNIFESP), Department of Microbiology, Immunology, and Parasitology, São Paulo, Brazil; CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands; Federal University of Pará, Science Biologic Institute, Belém, Pará, Brazil

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Paracoccidioidomycosis (PCM), the most important human systemic mycosis in Latin America, is known to be caused by at least four different phylogenetic lineages within the Paracoccidioides brasiliensis complex, including S1, PS2, PS3, and Pb01-like group. Herein, we describe two cases of PCM in patients native from the Amazon region. The disease was originally thought to have been caused by P. brasiliensis. Despite the severity of the cases, sera from the patients were negative in immunodiffusion tests using the standard exoantigen from P. brasiliensis B-339. However, a positive response was recorded with an autologous preparation of Paracoccidioides lutzii exoantigen. A phylogenetic approach based on the gp43 and ARF loci revealed high similarity between our clinical isolates and the Pb01-like group. The occurrence of PCM caused by P. lutzii in the Brazilian Amazon (Pará State) was thus proven. The incidence of PCM caused by P. lutzii may be underestimated in northern Brazil.

Author Notes

*Address correspondence to Silvia Helena Marques-da-Silva, Instituto Evandro Chagas-IEC/SVS/MS, Seção de Bacteriologia e Micologia, Laboratório de Micologia, Rodovia BR316, Km 07, s/n°, Levilândia, Ananindeua-Pará-Brasil, 67.030-000. E-mails: marquespb339@gmail.com or silviasilva@iec.pa.gov.br

Financial support: A. M. Rodrigues is a fellow and acknowledges the financial support of the Fundação de Amparo à Pesquisa do Estado de São Paulo (2011/07350-1) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (BEX 2325/11-0). Z. P. de Camargo thanks the financial support received from FAPESP (2009/54024-2).

Authors' addresses: Silvia Helena Marques-da-Silva, Instituto Evandro Chagas – IEC/SVS/MS, Seção de Bacteriologia e Micologia, Ananindeua, Pará-Brasil, E-mail: silviasilva@iec.pa.gov.br. Anderson Messias Rodrigues, Universidade Federal de São Paulo (UNIFESP), Departamento de Microbiologia, Imunologia e Parasitologia, São Paulo, São Paulo- Brazil, and CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands, E-mail: rodrigues_bio@yahoo.com.br. G. Sybren de Hoog, CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands, E-mail: s.hoog@cbs.knaw.nl. Fabíola Silveira-Gomes, Universidade Federal do Pará, Instituto de Ciências Biológicas, Belém, Pará- Brazil, E-mail: fabiolagomes@ufpa.br. Zoilo Pires de Camargo, Universidade Federal de São Paulo (UNIFESP), Departamento de Microbiologia, Imunologia e Parasitologia, São Paulo, São Paulo- Brasil, E-mail: zpcamargo@unifesp.br.

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